Capsular contracture?

My right breast implant has never felt comfortable. The right breast moved more and more of the implant could be felt underneath and at the side, surgeon said it was within 'normal' boundaries. 14 months after surgery I developed a large seroma, followed by another 3 months later. Fluid came back negative for infection. I now have hardening in this breast. I'm 6 months post the last seroma. Could the situation be due to poor placement? I'm currently 7 month pregnant. Replace or remove?

Doctor Answers 9

Contracture

I am sorry you are having issues with your implants.  It all depends on your goals.  If you no longer want implants, then removal with fat grafting to your breasts can be an option once you are finished with your pregnancy.  Best wishes.


New Orleans Plastic Surgeon
5.0 out of 5 stars 45 reviews

Capsule formation is normal in breast augmentation

Seroma 14 months following your breast augmentation is unusual but I do not think that this was
due to poor placement.

Capsule formation is a normal part of breast augmentation, but when it goes hard it has contracted and the causes of this are not totally understood.

I suggest that you need to be reviewed in the near future but I certainly would not entertain any form of corrective surgery until after you have had your baby.

I hope this helps, all the best.

Capsular contracture?


Thank you for your photo and your question.It is very difficult to evaluate whether or not you should have a capsular contracture without an in-person examination.The fact that you are currently 7 months pregnant, requires that you would wait for any surgical intervention until after your baby is born.My advice is to consult with a board certified plastic surgeon after the delivery of your child.I wish you the best luck.

Post Op Complication

Hello,

Thank you for your question. I'm sorry to hear about the issues that you have had, though they do not seem related to a problem with placement. If you are pregnant it will likely be best that you wait until your body has settled at least a few months after surgery before considering surgery. I recommend that you follow up closely with your Plastic Surgeon for advice.

All the best!

Capsular contracture?

I would advice seeing your operating surgeon in person, even though surgery will not be an option until after you deliver. Here is a little information on capsular contracture in the meantime.

The hallmark of contracture is one breast becoming firm and moving up towards your collarbone causing the nipple to rotate downward and can even be painful. Capsular Contracture is not well understood, and a single cause has not been identified. Leading theories include: subclinical venous bleed, low level bacterial contamination and/or biofilm, lint contamination from sterile drapes and genetic predisposition. Since the cause is unknown, treatment typically involves addressing all possible causes. There are four grades of contracture. Grade I is normal, looks good and feels soft and does not require treatment. Grade II feels firm but otherwise looks good. Grade III feels firm and looks distorted at rest. Grade IV feels firm, looks distorted at rest and is painful. Aggressive massage +/- Leukotriene Inhibitors can improve/soften Grade II contracture but in Dr. Feldman’s experience rarely improve the superior malposition present in Grade III and Grade IV contracture. These respond best to surgical revision/capsulectomy and implant exchange. Hope this helps.

Capsular Contraction

Sadly, capsular contraction is a limitation of breast augmentation and will occur in a proportion of people.  It is not related to poor placement of the implant.
With you being pregnant, any consideration of further treatment needs to be delayed until your breasts have settled.  At that stage, I would suggest you seek an opinion from a BAAPS member.
I hope your pregnancy goes well.

Douglas McGeorge, MBChB
Liverpool Plastic Surgeon
4.0 out of 5 stars 4 reviews

Implants

Hello, I would recommend evaluation with a board certified plastic surgeon who can give a second opinion based on your exam and history. If you are 7 months pregnant...any options would likely occur after you have delivered. Good Luck.

Remove or replace breast implants?

To remove or to replace- this is an extremely personal choice. Find a reputable board certified plastic surgeon in your geographical area and schedule a consultation. Upon examination your surgeon will be able to recommend your treatment options. Best of luck to you!

Christine Sullivan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 28 reviews

Late seroma, rule out implant associated ALCL

There can be many causes of a late seroma and a persistent late seroma should have fluid sent off to make sure it is not something more worrisome, including implant associated ALCL. The American Society of Plastic Surgery has great resources on this. Follow up with your board certified plastic surgeon is important. Best, MMT

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.